Marc Lange THL-OPER yhteistyöseminaari 26.-27.3.2014 Oulu,Peer review swot fi v05

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THL-OPER yhteistyöseminaari 26.-27.3.2014 Oulu,

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Marc Lange THL-OPER yhteistyöseminaari 26.-27.3.2014 Oulu,Peer review swot fi v05

  1. 1. Implementation of eHealth solutions in Europe – where does Finland stand? Marc Lange, Secretary General
  2. 2. Competence Centre Health Care Authorities Industry Health Care Delivery Citizens/Patient Representative Innovation Agency Insurers Social Care Dissemination Organisation European Health TELematics A cross-(any)border and multidisciplinary collaboration forum OPER cooperation seminar - Oulu 26 March 2014 2 Sustainable and large scale eHealth deployment requires engagement and synergies
  3. 3. Our Activities OPER cooperation seminar - Oulu 26 March 2014 3
  4. 4. OPER cooperation seminar - Oulu 26 March 2014 Our platform enables an overview 4
  5. 5. EHTEL Peer Review One of the EHTELconnect services proposed by EHTEL to its members Objective: to assist organisations • in self-benchmarking • their eHealth strategy / action plan / implementation • with similar communities Ran for the first time in 2009 for the MoH of Sweden OPER cooperation seminar - Oulu 26 March 2014 Recommended by in 2010 5
  6. 6. Outcome of an EHTEL Peer Review A two-day workshop • During which the programme/project managers from the inviting organisation(s) • Present and discuss their eHealth programme and projects • Before an audience of “Peers”, member of the EHTEL Network A workshop report • Compiles the presentations and the discussions among experts • Concludes with observations organized in the form of a OPER cooperation seminar - Oulu 26 March 2014 6
  7. 7. The Peer Team Multi-stakeholder • Consultancy organisations • Service delivery organisations • Public authorities • Industries Multi-disciplinary • Physicians, pharmacists, economists, IT and Business administration experts, experts in political science European/international • Belgium, Denmark, Estonia, France, Germany, Israel, Netherlands, Norway, Sweden, United Kingdom (England & Scotland). OPER cooperation seminar - Oulu 26 March 2014 7
  8. 8. OPER cooperation seminar - Oulu 26 March 2014 8
  9. 9. Disclaimer Overall, the presentations made were considered by the peer review experts to be comprehensive and detailed. However, they could have been improved regarding two areas of focus. • First, throughout the series of presentations, no precise “case studies” were discussed in any detail. • Second, there were no presentations from senior clinicians or more local operational managers (such as domain experts and champions). OPER cooperation seminar - Oulu 26 March 2014 9
  10. 10. Scope: the eHealth National Architecture OPER cooperation seminar - Oulu 26 March 2014 10
  11. 11. Aholisticconceptfor eHealth Foundation eHealth infostructure Patient identification and patient data discovery Data structures and value sets EHR, EMR, PHR, other Clinical terminologies and classifications and codifications Data and knowledge management tools HCP Authorization, authentication and rights management Consent management and access control Data interoperability and accessibility Data bases and Registries eHealth Governance Market development, new business models, and incentives Privacy, quality and safety policies Legislative and regulatory framework Financing, Resource allocation and reimbursement models eHealth leadership, policy and strategy EU & National Stake- holder collaboration Fostering standards adoption Monitoring, evaluation Sustainable Healthcare Sharing Information and Knowledge for Better Health eHealthServices Patientsummaries Electronicprescribing ChronicCareManagement Communityservices,AAL Evidence-basedpublichealth Populationstratification Tele-consultation Tele-diagnostic Secondopinion Tele-medecine Tele-… Foundation ICT infrastructure Mobile and fixed Electronic Communication Infrastructures ICT processing and storage services ICT Professional and technical support; Training Access to ICT Networks, equipment and facilities 26 March 2014OPER cooperation seminar - Oulu Patientsummary ePrescription Patientaccess HealthCarePlan KanSa Remotemonitoring? Healthcoaching? … 11
  12. 12. Strengths (internal origin/helpful) World-level benchmark A strategic change management programme • It provides a compelling vision of integrated care • It is supported by an appropriate legislation to meet • Societal and financial challenges and • The need to modernise the health and social care systems Quality deployment process: • Early start, hence there is already a long experience • General overcoming of resistance to change (e.g. through education) OPER cooperation seminar - Oulu 26 March 2014 13
  13. 13. Strengths (…) Finland is sitting on a metaphorical "gold mine" • The quantity, timeliness and quality of health data entered and collected from routine healthcare is impressive. • Almost all records are “electronic from birth” • Today, the country has direct access to a source of valuable information and resources OPER cooperation seminar - Oulu 26 March 2014 14
  14. 14. Weaknesses (internal origin/harmful) The context of care: • New care pathways, chronic disease management, patient empowerment are required for modernising the health and social care system. Healthcare practitioners could have a more proactive role: • They should act as coaches and guides to support health care improvement, working with "communities of patients" or "communities of providers". OPER cooperation seminar - Oulu 26 March 2014 15
  15. 15. Weaknesses (…) Limited return-on-investment and benefits analysis: • Because an infrastructure is mainly an enabler and requires services to deliver clinical and economic value The policy behind the tools: • To focus on what the health system overall is attempting to achieve OPER cooperation seminar - Oulu 26 March 2014 16
  16. 16. Opportunities (external origin/helpful) Policy, governance and organisation • Invitation from Mr. Esko Aho to seek for positive disruptive innovation in the Finnish health/social care system • The creativity of the actors involved, which requires appropriate incentives to act Leadership, business and benefits • Finland has a leadership position with regards to the transformation of health and social care systems • Need for evidence on clinical effects of the changes to the system and their measurement • Need for quantitative indicators e.g. on adverse events OPER cooperation seminar - Oulu 26 March 2014 17
  17. 17. Threats (external origin/harmful) The demand for personal health data • This may put the service provision under stress Information is not knowledge • Risk of overload of information because of the volume of collected data The value and sensitivity of the data • This increases risks OPER cooperation seminar - Oulu 26 March 2014 19
  18. 18. Highlights The eHealth infrastructure is there! • Technical building blocks • Legal framework • Issue: interoperability for system openness and agility • Challenge: an infrastructure does not deliver value, it is only an enabler eHealth and Telemedicine services will • Add value • Deliver benefits OPER cooperation seminar - Oulu 26 March 2014 20
  19. 19. Aholisticconceptfor eHealth Foundation eHealth infostructure Patient identification and patient data discovery Data structures and value sets EHR, EMR, PHR, other Clinical terminologies and classifications and codifications Data and knowledge management tools HCP Authorization, authentication and rights management Consent management and access control Data interoperability and accessibility Data bases and Registries eHealth Governance Market development, new business models, and incentives Privacy, quality and safety policies Legislative and regulatory framework Financing, Resource allocation and reimbursement models eHealth leadership, policy and strategy EU & National Stake- holder collaboration Fostering standards adoption Monitoring, evaluation Sustainable Healthcare Sharing Information and Knowledge for Better Health eHealthServices Patientsummaries Electronicprescribing ChronicCareManagement Communityservices,AAL Evidence-basedpublichealth Populationstratification Tele-consultation Tele-diagnostic Secondopinion Tele-medecine Tele-… Foundation ICT infrastructure Mobile and fixed Electronic Communication Infrastructures ICT processing and storage services ICT Professional and technical support; Training Access to ICT Networks, equipment and facilities 26 March 2014OPER cooperation seminar - Oulu Patientsummary ePrescription Patientaccess HealthCarePlan KanSa Remotemonitoring? Healthcoaching? … 21
  20. 20. Developing eHealth and Telemedicine services eHealth and Telemedicine services • Medical components • Clinical evidence • Issue: the actual needs of health professionals and patients • Challenge: user adoption This is about changing from • Data to services • Data collection to data integration in processes • Tools to process redesign / new care pathways OPER cooperation seminar - Oulu 26 March 2014 22
  21. 21. OPER cooperation seminar - Oulu 26 March 2014 23 New Technology + Old System = New Old System
  22. 22. Patient’s home South Karelia Social and Health Care District (Eksote) 5 32 4 HEALTH COACH 1 PATIENT WEB PHR APPLICATION GATEWAY HOSPITAL SPECIALIST GENERAL PRACTITIONER 6 TELEMONITORING DEVICES DATA TRANSMISSION DATA ACCESS THROUGH HOME CARE PORTAL ALARM MANAGEMENT Tele-monitoring for Diabetes & CVD South Karelia © 26 March 2014 OPER cooperation seminar - Oulu 24
  23. 23. 26 The MAST model If the purposes of an assessment of telemedicine applications are: – To describe effectiveness and contribution to quality of care AND – To produce a basis for decision making The relevant assessment should be defined as: The assessment of telemedicine should be a multidisciplinary process that summarizes and evaluates information about the medical, social, economic and ethical issues related to the use of telemedicine in a systematic, unbiased, robust manner. MAST Model for ASsessment of Telemedicine 26 March 2014 26
  24. 24. Multidisciplinary assessment (domains): 1. Health problem and characteristics of the application 2. Safety 3. Clinical effectiveness 4. Patient perspectives 5. Economic aspects 6. Organisational aspects 7. Socio-cultural, ethical and legal aspects Transferability assessment: • Cross-border • Scalability • Generalizability Elements in MAST 26 March 2014 28
  25. 25. 26 March 2014 A European Telemedicine Deployment Blueprint OPER cooperation seminar - Oulu 29
  26. 26. Testing of Service Routine Care Service Small Scale Deployment Large Scale Deployment Hospital Group Department Department HealthCare System Piloted Service Lessons learned from deployment inside an organisation  Local champions  Limited constraints (e.g. at legal level)  Cost and benefit analysis  … Lessons learned from deployment across organisations (for servicing the healthcare system)  Institutional endorsement  Legal constraints (if it is a D2P relationship)  Need for robust methods  Socio-economic analysis  … From pilot to routine care 26 March 2014OPER cooperation seminar - Oulu 30
  27. 27. OPER cooperation seminar - Oulu 26 March 2014 Identify the problem Recognize the need for change Explore Search for a solution Build Create, test and assess potential impact Apply and Monitor From pilot to real life Social Innovation Cycle 31
  28. 28. OPER cooperation seminar - Oulu 26 March 2014 Marc Lange Secretary general EHTEL Association 49/51, rue de Trèves B-1040 Brussels Belgium Tel: +32 (0)2 230 15 34 Fax: +32 (0)2 230 84 40 Mobile: +32 (0)475 27 71 45 Marc.Lange@ehtel.eu www.ehtel.eu 33 Any questions?

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